Individual
PRITHAM PINGLI REDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22250 PROVIDENCE DR, SUITE 555, SOUTHFIELD, MI 48075-4825
(248) 424-5748
(248) 443-1706
Mailing address
22250 PROVIDENCE DRIVE, SUITE 555, SOUTHFIELD, MI 48075
(248) 424-5748
(248) 443-1706
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301075046
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P33080
PTAN
MI
05
—
1587302
—
MI
Enumeration date
05/08/2007
Last updated
01/12/2015
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